Donna M. Zulman, M.D. wrote in a recently published JAMA article about Francis Peabody’s presentation to Harvard Medical School, 90 years ago, about the complex and deeply human experience of illness, that “the secret of the care of the patient is in caring for the patient”. This is such a powerful observation, wrote Doctor Zulman, that we must know more.
Those who create marketing programs for the world of audiology, as they seek to enter the world of medicine to access new patients, would do well to internalize those words, and contemplate how they may bring additional solutions that help the physician meet their daily challenges in the comprehensive care of their patients.
Let’s address the following physician priorities. “Efficacy, Side Effects, and Cost”, with an emphasis on “efficacy”. Whether the physician is deliberating about a new medication, an innovative treatment process, or a proven surgical procedure, “efficacy”, (it works!) always comes first.
How can audiology help? The very definition of “Patient Engagement” provides us with some answers: “Providers and patients working together to improve health. A patient’s engagement in healthcare contributes to improved health outcomes, and information technologies can support engagement. Patients want to be engaged in their healthcare decision-making process, and those who are engaged as decision-makers in their care tend to be healthier and have better outcomes”. (Ref: Patient Engagement, Health IT Topics, HIMSS 6/13/2016).
Audiology hearing care professionals can ensure that the patient can hear the physicians verbal instructions. We can make sure that we provide testing and treatment for at risk patient populations, (diabetics, smokers, cardiovascular disease patients, those exposed to toxic noise, and the aged patient to name a few) to reduce the unacceptably high incidence of depression in these patients with untreated hearing loss. (Approximately 12 percent, versus 6 percent for those whose hearing loss has been treated). Depression is a significant risk-factor for non-compliance with medical treatment. Compared with non-depressed patients, the odds are 3 times greater that depressed patients will be non-compliant, or not engaged, with medical treatment recommendations.
Age related hearing loss has been found to be independently associated with poor cognitive functioning and incident dementia. Those with mild, moderate, and severe hearing loss had a 2-, 3-, and 5-fold increased risk of developing dementia, respectively. Although the effects of Age Related Hearing Loss on cognitive pathways have yet to be fully elucidated, its effects on impaired verbal communication and reduced social engagement are commonly accepted. Ref: F. Lin M.D. JAMA, March 21, 2012 – Vol 307, No 11.
Older adults with mild-to-moderate hearing loss performed poorer on cognitive tests than those of the same age who had good hearing. Most of a physicians directions to his/her patients are verbal. A patient with hearing loss and cognitive decline has to be at risk for “lack of engagement”, thus delaying or aborting the likelihood of achieving efficacy, and a potential improvement in quality of life. Hearing healthcare professionals can help alleviate the risk to the ARHL patient by testing and treating the hearing loss.
Audiology providers can altruistically distribute authoritative research about the various life-style related co-morbid conditions that are proven to be independent risk factors for hearing loss, so that the physician may be more effective with his or her “risk versus benefit” counseling. More patients will get care! Audiology may provide further benefit for the physician as they seek efficacy, improvement in patient quality of life, and an overall lower cost of care by providing patient education material about the disease state of hearing loss, in both English and Spanish. Poor health literacy causes limitations for patients that are clearly hazardous to health.
By hearing healthcare providers seeking partnerships in patient care with primary care physicians, audiology can help improve communication between physician and patient in the exam room, may alleviate a significant cause of depression which is a barrier to care, and may improve the patients understanding of their diagnosis so that they are “engaged enough to be decision-makers in their care, become healthier, and achieve better outcomes”.
When providers, patients, and hearing care specialists work together to improve health we have a compelling mission we can all believe in!
I respectfully thank you for your interest.